IVF vs IUI: What Is the Difference?

IVF vs IUI: what is the difference? In this video, Mark P. Trolice, M.D., a board certified reproductive endocrinology and infertility specialist and founder of Fertility CARE: The IVF Center discusses these two fertility treatment options.
“There is a lot of confusion among patients when I talk about IVF and IUI,” says Dr. Trolice. “These are the alphabet soup terms in our field. IUI stands for intrauterine insemination. That’s where we have a tiny catheter that passes sperm through the cervix into the uterine cavity to improve fertility. IVF or in vitro fertilization, removes eggs from a woman’s ovaries and insemination occurs for fertilization in the laboratory, and then we transfer an embryo back inside the woman’s uterus.”
Both IVF and IUI have distinct advantages and disadvantages. IUI is generally termed artificial insemination. There are many reasons why a woman or couple would want to choose IUI cycles, or fertility medication combined with IUI cycles.
“Do we ever use IUI without medication?” asks Dr. Trolice. “Yes, an easy example would be donor sperm with a single woman, same-sex couple, or a heterosexual couple where the man doesn’t have sperm. We can obtain sperm from a donor bank and gently pass that into the uterine cavity with IUI when a woman ovulates.”
“There are two ways we can use fertility medication,” Dr. Trolice continues. “One is to get a woman to ovulate when she’s not. The goal is to produce one or maybe two follicle cysts with an egg. The other way is to increase the number of eggs that a woman ovulates each month. Medication will be used to increase the odds.”
Dr. Trolice notes that his clinic is very conscious of the risk of multiple births and him and his staff do everything to try to reduce that.
“When we talk about IUI cycles for fertility treatments, that’s when we give the woman medication to increase the number of eggs during ovulation,” says Dr. Trolice. “When we monitor these patients, they will either ovulate naturally or be given a trigger shot to mature and release the eggs from the follicles.”
“Then we time the IUI - that’s done about 24-36 hours after the trigger injection, usually with a hormone called human chorionic gonadotropin (HCG),” Dr. Trolice continues. “The sperm (either from the donor or spouse) is taken and washed in a special gradient in the reproductive laboratory and concentrated into a very small total motility volume, containing five to ten million sperm.”
“The insemination is very simple and if the partner is in the room, we usually have them press the plunger to place the sperm inside the uterine cavity. The patient does not have to rest, in fact, a recent article showed that there is no advantage to resting after IUI.”
“Success with IUI is based on a woman’s age,” says Dr. Trolice. “About 10-20% of IUI patients get pregnant on a monthly basis. Typically, if a woman is ovulating, we’ll go about three months at which point you’ll see a rate of diminishing returns. If a woman doesn’t ovulate we’ll go up to four to six cycles.”
What is IVF?
IVF is where a woman is given injectable stimulating medication to produce multiple follicles with eggs. After about ten days of daily injections, ultrasound monitoring and blood work, the IVF procedure is done after the patient is given a trigger injection.
“But this time we don’t want the eggs to be released inside the woman’s body,” says Dr. Trolice. “We go in under ultrasound guidance, we sedate the woman with our anesthesiologist at our in-patient surgery center, we vacuum out the eggs in about 15-20 minutes, and the woman goes home within an hour.”
The sperm is then added to the eggs in the laboratory, and when the embryo forms and develop, is transferred back inside the woman’s uterus about 5 days later.
“IVF has a much higher pregnancy rate, based on age, compared to IUI,” says Dr. Trolice. “Certainly it’s more costly but IVF has numerous advantages over IUI such as extra embryos to freeze and the possibility to do chromosome testing. So there is additional need for consultation to discuss those two options.”
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Dr. Mark P. Trolice is the Director of Fertility Care: The IVF Center in Winter Park, Fla., the most comprehensive fertility center in the Southeast. A leader in the field of reproductive endocrinology, Dr. Trolice has helped countless patients become parents in central Florida since 1999.